Individual
TIFFANY L STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6633
Mailing address
1108 CREEKSIDE CIR, HINESVILLE, GA 31313-2574
(208) 283-6535
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/20/2020
Last updated
03/20/2020
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